Just because something can be done doesn’t mean that it is the way you’d want it done.
Yes. The scrotal skin and the nerves that innervate the testicles and vas deferens can be infiltrated with short and long acting anesthetics for very good control of pain. Oral medicines similar to what is used in “sedation dentistry” can be used as a sedative to further make non general anesthesia possible for a vasectomy reversal.
Why doesn’t everyone do it this way? Because the procedure usually lasts 2-3 hours some patients might not be comfortable lying still for that long. As well, because the operative microscope magnifies the operative field so much, small movements dramatically change the area seen and the focus settings. This in turn results in the surgeon having to readjust the microscope and in turn make procedure last longer. One might add that the occasional adjustments hamper the surgeon’s ability to do a quality repair of the vasectomy.
Another reason that a patient and the doctor might prefer local anesthesia with oral sedation is cost. Having general anesthesia must be done in a facility and that in it self adds an expense and then there is the anesthesiologist and the supplies necessary for general anesthesia.
The advantage to the patient with general anesthesia is that he is put to sleep and then wakes up and the procedure is done. For the surgeon he has had the advantage of not being concerned or dealing with a patient moving and having to readjust the microscope.
So in the end it becomes about patient and surgeon preference, and cost. At Northeast Georgia Urological Associates we believe we have the best of both worlds.
Because we own our center the added costs for a facility and anesthesia is minimized resulting in a very cost effective reversal without compromising safety and comfort by utilizing a board certified anesthesiologist in an accredited surgery center.
Obviously there are a lot of reasons for a man choosing to reverse a vasectomy. The two most common reasons are:
- The male is divorced, has had children and a vasectomy. He then remarries a younger woman who has not had children and wants to have children. Often times the discussion regarding the male undergoing the inconvenience and expense of a reversal and his willingness to have it done, occurs before the couple is married.
- A couple with several children decide after vasectomy they’d like to have more children. Interesting enough, in my practice, this reason for having a reversal is increasing.
Regardless of the reason we at Northeast Georgia Urological Associates look forward to helping you with a new addition to your family.
As a side note, the other day a patient told us that another doctor could tell him what he’d charge for a reversal but could not tell him what the hospital would be charging. In fact, the doctor told the patient to call the hospital to find out the costs. Because we own our Surgery Center we will be able to tell you exactly what the total cost will be and because we don’t use a hospital our costs are lower than most reversal centers.
This real phenomenon in my experience happens rarely, but it happens. There are reports that show that doing a reversal has been dramatically beneficial.
The reversal surgeon however cannot assure that there will be resolution of symptoms if a reversal is done. This should weigh heavily in the decision making process of the patient wanting to pursue this.
I will mention that I performed a reversal on a man who wanted children but also felt he had PVPS. He wrote me after the procedure stating that he had had complete resolution of his pain and was very pleased.
Here are several links on the discussion of this:
Review of literature-Note those patients that did not improve with reversal.
Yes…but that doesn’t mean it will work!
This is a common question by the person wanting a vasectomy. I often explain that yes they are reversible but that is not the entire issue. As explained elsewhere, there are many factors involved in a “successful” reversal to include the health of the couple, who does the reversal and the time between the reversal and the vasectomy.
Urologists always tell the vasectomy couple that they should consider the procedure permanent. We mention that it can be reversed but the success rates vary and that they should not depend on that.
If there is any doubt about wanting another child you probably are not ready to nor should you have a vasectomy.
A good option for some is to bank sperm. The fee for this varies but is around $300 a year.
A funny memory for me… awaiting our third child my wife informed me that she did not want anymore children and that she had arranged for her tubes to be tied after the delivery. I asked, “What if you change your mind and we do want another one in a few years.” (I was one of five boys and had always wanted a large family.)
“John we can adopt. My body is done with having babies.”
Well…there you go. Having three children now all over the age of thirty I understand the wisdom of her decision.